Trampolines can cause serious injuries; use should be discouraged
KaliTileston, M.D., FAAP and Ellen M.Raney, M.D., FAAP
Focus on Subspecialties
Many people consider trampolines a backyard staple along with barbecues and lounge
chairs. However, the recreational use of trampolines is a relatively modern phenomenon.
Trampolines were developed in 1945 as a training tool for acrobats and gymnasts. The
use of trampolines as a leisure activity has largely been driven by marketing and
increased availability of inexpensive trampolines promoted for home use and exercise.
Parents are well aware of other backyard dangers such as swimming pools and take significant
precautions to protect their children. However, they still unwittingly allow their
children to play on trampolines.
The rates of trampoline injuries are similar to those in swimming pools, according
to the U.S. Consumer Product Safety Commission National Electronic Injury Surveillance
System. Between 2002 and 2011, there were over 1 million emergency department (ED)
visits for trampoline injuries with the vast majority in patients younger than 17
years (Loder RT, et al. J Pediatr Orthop. 2014;34:683-690).One-third of these injuries resulted in broken bones, and one in 200 led to permanent
Younger children are much more likely to sustain an injury on a trampoline, especially
when bouncing with an older or larger child. These young children have the highest
risk of severe injuries, including spine and lower extremity fractures. Approximately
75% of trampoline injuries occur when more than one child jumps at a time, and the
smaller child is approximately 14 times as likely to be injured as the larger one
(Wootton M, Harris D. Emerg Med J. 2009;26:728-731).
The cost of these injuries to the U.S. health care system is astronomical. From 2002
to 2011, the ED expense for treating these injuries was over $1 billion (Loder RT,
et al. J Pediatr Orthop. 2014;34:683-690).
The rise of commercial trampoline parks has demonstrated an increased risk of orthopedic
injuries as well as injuries requiring surgical intervention (Doty J, et al. J Am Acad Orthop Surg. 2019;27:23-31). Between 2011 and 2014, the number of ED visits from injuries sustained at trampoline
parks rose more than 10-fold from 600 to almost 7,000. Injuries at trampoline parks
are more likely to be musculoskeletal in nature with a higher risk of dislocations
and sprains, whereas home trampolines demonstrate a higher risk of head injuries and
lacerations (Kasmire KE, et al. Pediatrics. 2016;138(3):e20161236).
Trampoline park injuries have a 1.7 times higher likelihood of requiring admission
to the hospital, have a longer length of stay if admission is required and are more
costly to treat compared to injuries sustained at home (Kasmire KE, et al. Pediatrics. 2016;138(3):e20161236; Chen M, et al. J Paediatr Child Health. 2019;55:175-180).
However, more than 85% of injuries still happen at home. AAP policy advises pediatricians
to counsel their patients and families against recreational trampoline use. If families
persist in using home trampolines, pediatricians should recommend they adhere to the
Somersaults and flips should be discouraged. Failed attempts at these maneuvers can
cause devastating cervical spine injuries, resulting in permanent disability or even
Only one child should be allowed on the trampoline at a time.
Never allow children to jump without supervision. The supervising adult should be
willing and able to enforce the recommendations above and should never leave children
Netting and other safety equipment have not been shown to decrease trampoline-related injuries. Vigilance is necessary when using
any type of trampoline, even trampolines with safety devices.
Springs should be covered with padding to avoid pinching fingers or toes and to protect
against falling into the crevice between the springs.
Trampolines should be inspected regularly for tears, rust and detached springs or
Keep ladders away from trampolines as they provide a mechanism for small children
to get on the trampoline and jump without supervision.
Homeowners with a trampoline should verify that their homeowner’s insurance covers
The use of trampolines as recreational structures should not be taken lightly, and
parents should have an appropriate understanding of the risks. Safety precautions
for trampoline use should be viewed in a similar light as those for swimming pools.
The safest option is for families to simply not have a trampoline. However, if they
choose to have one, strict rules should be set and precautions followed.
Drs. Tileston and Raney are members of the AAP Section on Orthopaedics.